| Abstract |
This study develops an analytical framework for future system design based on the 2024 ambulance records of the Taipei City Fire Department. It integrates prehospital criticality assessments, emergency department triage levels, and usage frequency to classify cases into ˇ§normal use,ˇ¨ ˇ§gray zone,ˇ¨ and ˇ§obvious misuse.ˇ¨ Empirical results show that gray-zone and higher cases are the core sources of EMS capacity strain, and the gap between prehospital urgency judgments and hospital triage levels reflects ineffective prehospital diversion. The study proposes amendments to Articles 12-1 to 12-3 of the Emergency Medical Services Act to establish unified dispatch prioritization, reassessment and refusal-of-transport protocols, and cross-agency data linkage mechanisms. It further suggests a differentiated fee model supported by public insurance to recover costs and reduce unnecessary transports. The proposed optimization frameworkˇXcentered on reassessment callbacks, real-time medical oversight, and multi-tier diversion pathwaysˇXforms a closed-loop EMS process. Additional measures include dynamic dispatch and capacity balancing, data-driven decision support, dedicated non-emergency fleets, and incentive-based workforce schemes to sustain EMS quality through interagency information sharing and integration. |
